Pataki C S, Carlson G A, Kelly K L, Rapport M D, Biancaniello T M
Department of Psychiatry, New York University School of Medicine, NY 10016.
J Am Acad Child Adolesc Psychiatry. 1993 Sep;32(5):1065-72. doi: 10.1097/00004583-199309000-00028.
To investigate side effects of methylphenidate and desipramine alone and in combination in hospitalized children with symptoms of attention-deficit hyperactivity disorder and depression.
A double-blind placebo controlled crossover design was used to investigate each medication alone and in combination. Side effect ratings and EKGs were done weekly. Pulse and blood pressure were monitored daily.
Nausea, dry mouth, and tremor were present in at least twice as many children on combined methylphenidate and desipramine compared with any other condition. Nausea/vomiting, headaches, other aches, refusal of food, and feeling "tired" were significantly more frequent during the combined methylphenidate plus desipramine condition when compared with either methylphenidate alone or with baseline. Significantly higher ventricular heart rate was found on combined methylphenidate plus desipramine compared with desipramine alone, methylphenidate alone, and baseline. Prolonged PR interval and significantly higher heart rate occurred during desipramine alone compared with baseline.
During the several-month duration of the study, there were more frequent side effects during combined methylphenidate plus desipramine treatment than with either medication alone. Clinically, side effects present during combined medication appeared to be similar to and no more serious than those associated with desipramine alone.
研究哌甲酯与去甲丙咪嗪单独及联合使用对患有注意力缺陷多动障碍和抑郁症症状的住院儿童的副作用。
采用双盲安慰剂对照交叉设计来研究每种药物单独及联合使用的情况。每周进行副作用评级和心电图检查。每天监测脉搏和血压。
与其他任何情况相比，联合使用哌甲酯和去甲丙咪嗪的儿童中出现恶心、口干和震颤的人数至少是其他情况的两倍。与单独使用哌甲酯或基线相比，在联合使用哌甲酯加去甲丙咪嗪期间，恶心/呕吐、头痛、其他疼痛、拒食和感觉“疲倦”的情况明显更频繁。与单独使用去甲丙咪嗪、单独使用哌甲酯和基线相比，联合使用哌甲酯加去甲丙咪嗪时心室心率明显更高。与基线相比，单独使用去甲丙咪嗪时出现PR间期延长和心率明显升高。
在为期数月的研究中，联合使用哌甲酯加去甲丙咪嗪治疗期间的副作用比单独使用任何一种药物时更频繁。临床上，联合用药时出现的副作用似乎与单独使用去甲丙咪嗪时相似，且并不更严重。
